Two Special Years of Intense CSNS Activity – From the Council of State Neurosurgical Societies

Mark E. Linskey, MD

I have been honored and privileged to serve as the CSNS Chair from 2013 to 2015. In two previous articles written for Congress Quarterly, I outlined our vision and goals for those 24 months and then reported on our interim progress. I am very happy to say that the majority of what we set out to do is either completed or nearing completion, and that we have even expanded the original vision to include significant additional goals, which have now also been met.

In regards to our number one goal of transforming the CSNS into a truly integrated state and regional advocacy platform, we have come a very long way in a very short time. In collaboration with the Washington Office, we are piloting two initiatives utilizing two new software programs. The first is a state legislative monitoring software module (State Track) purchased as an add-on to the existing CQ Roll Call© software already utilized within our Washington Office for federal legislative monitoring purposes. Our first initiative will test real-time monitoring and communication between the CSNS, the Washington Office, and the state piloting the program in terms of monitoring and proactively engaging on planned or new state legislation with potential for significant impact on state and regional delivery of neurosurgical care to our patients. The second new software is Policy Reporter©, a program designed to provide an ongoing means of staying abreast of third party health care provider policy changes across payer populations within any given region. Our second initiative will test real-time monitoring and communication between the CSNS, the Washington Office, and the state piloting the program in terms of monitoring and proactively engaging on planned or new third party payer policy changes with potential for significant impact on state and regional delivery of neurosurgical care to our patients. Both initiatives are underway for 2015 and should report their results in 2016.

After extensive study as to how the CSNS can support the infrastructure and operational needs of existing state neurosurgical societies in terms of helping to manage membership, dues, communication, and meetings, and additionally helping areas without state neurosurgical societies to organize and develop them, we have decided to take a professional outsource approach. The CSNS is in negotiation with a very experienced medical professional society and medical meeting management company to enter into a preferred vendor relationship. The concept would include CSNS endorsement of the vendor to provide professional services to our neurosurgical state societies at a significant discount, to assist us in new society and society revival initiatives, and to link with the CSNS for state society member identification and communication efforts. We hope to have a memorandum of understanding in place this year.

The CSNS has worked to emphasize and develop neurosurgery-specific patient safety and to provide neurosurgery input at the national educational and quality-assessment levels through our patient safety ad hoc com-mittee. These efforts have led to two spring 2015 CSNS resolutions: first, to create a safety fellowship at the Institute for Health Care Improvement; second, to create a workgroup for patient safety within the quality committee of the Washington Office. These work products will insure that neurosurgery-specific patient safety continues into the future as a priority emphasis issue.

Within one short year, working with our closely affiliated sister organization NERVES, we have been able to develop a working model of a medical practice training simulator. When complete, this simulator will be the latest in simulation education for socioeconomics in neurosurgery. It will allow trainees to respond to changes in a number of variables and see how each change affects the other relevant variables. Trainees will be able to model the effectiveness of different responses to these changes. This simulator is now in final devel-opment for anticipated roll out within the next six to twelve months.

During the same time frame, we have formed a special Affordable Care Act (ACA) Dissection and Pro-active Monitoring Task Force to digest and understand the ACA, monitor the ACA implementation timeline and evolving changes, and proactively anticipate implications for neurosurgery. This will allow us to create resolutions to promote education and discussion, as well as to act in sufficient time to make a difference through our CSNS reso-lution process and feed-forward to the CSNS Communications and Education Committee (CEC) for inclusion in the CNS annual meeting educational program and other meetings.

As if these milestones weren’t enough, within the last two years we have successfully re-invigorated the CSNS CEC and Young Neurosurgeon Representative Sections to unprecedented levels of CSNS delegate participation. We have reestablished and strengthened our relationship with NERVES, AANN, and the ANSPA. We have developed a new role for CSNS standing committees as review platforms for NREF grant with socio-economic content and/or focus. We have begun an exploration of the integration of patient advocacy into all our work processes and products. We are exploring the needs and characteristics of neurosurgeons as hospital and corporate medical directors, a new area of employment that may benefit from CSNS participation as a representative section. At the same time, we have completed the Melany Thomas CSNS Resident Fellowship endowment and established another year of stable funding for our very successful CSNS resident fellowship program.

As I complete my term as CSNS Chair, I do so with considerable pride regarding the hard work, efforts, and accomplishments of so many colleagues and emerging national neurosurgery leaders that I do not have space enough to name here. I was blessed this past two years with an outstanding group of officers and an Executive Committee second to none. We set a very ambitious agenda, and through dedication, hard work, and organization, we saw it through.

The CSNS is one of the premier organizations within national organized neurosurgery. We are the socio-economic section and the grassroots advocacy house of delegates for all neurosurgeons nationally. We welcome any and all ideas and offers of support and assistance in our efforts. As I leave the chair position, I have no doubt that the CSNS is in excellent hands going forward. I look forward to seeing what comes next, and I leave all readers with the following admonition: Please step up and participate! Neurosurgery is our profession, neurosurgeons are the best advocates for our patients, and we need everyone involved.

WITHIN ONE SHORT YEAR, WORKING WITH OUR CLOSELY AFFILIATED SISTER ORGANIZATION NERVES, WE HAVE BEEN ABLE TO DEVELOP A WORKING MODEL OF A MEDICAL PRACTICE TRAINING SIMULATOR. WHEN COMPLETE, THIS SIMULATOR WILL BE THE LATEST IN SIMULATION EDUCATION FOR SOCIOECONOMICS IN NEUROSURGERY. IT WILL ALLOW TRAINEES TO RESPOND TO CHANGES IN A NUMBER OF VARIABLES AND SEE HOW EACH CHANGE AFFECTS THE OTHER RELEVANT VARIABLES.